How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $2.29 | Facility | None | $1.26 | $1.26 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.41 | Professional | None | $1.26 | $1.26 | $1.41 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.12 Median $3.16 Typical High $4.07 | Facility | None | $1.12 | $3.16 | $4.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.26 Median $1.38 Typical High $2.09 | Professional | None | $1.26 | $1.38 | $2.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.26 Median $1.41 Typical High $2.57 | Facility | None | $1.26 | $1.41 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $2.63 Typical High $5.37 | Facility | None | $1.62 | $2.63 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.45 | Professional | None | $1.26 | $1.26 | $1.45 |
Fallon Health Setting Facility Modifier None Typical Low $1.26 Median $1.74 Typical High $2.04 | Facility | None | $1.26 | $1.74 | $2.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.95 Median $1.38 Typical High $2.09 | Professional | None | $0.95 | $1.38 | $2.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.12 Median $3.16 Typical High $4.07 | Facility | None | $1.12 | $3.16 | $4.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.26 Median $1.38 Typical High $2.09 | Professional | None | $1.26 | $1.38 | $2.09 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.34 | Professional | None | $1.38 | $1.38 | $2.34 |
Well Sense Setting Facility Modifier None Typical Low $1.51 Median $1.91 Typical High $2.88 | Facility | None | $1.51 | $1.91 | $2.88 |
Well Sense Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.51 | Professional | None | $1.26 | $1.26 | $1.51 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.63 Median $0.63 Typical High $0.65 | Professional | 52 · Reduced service | $0.63 | $0.63 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.20 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Oklahoma. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 32nd of 51
$1.38
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.